Although most sexual changes after cancer are caused by physical changes, some result from anxiety or depression. Therefore, it is important to have depression and anxiety assessed before having any sexual changes evaluated or treated. This is also important since anxiety and depression share some common symptoms with treatment side effects.

Fortunately, the anxiety and depression many people feel during cancer treatment fades with time for most. But if the emotional reaction to cancer does not improve within a few months of treatment, patients may benefit from some counseling, which can be as effective as medication for depression and anxiety. Also, it's important to know that some medicines prescribed to treat depression or anxiety can have sexual side effects.

Anxiety

Anxiety about cancer can preoccupy your thoughts, interfering with your ability to enjoy many activities, including sex. Worry and fear about the future may make it hard to share intimacy and affection. Anxiety is a treatable condition, however, responding to both counseling and medicine. Symptoms can be physical or emotional and include:

• Feeling apprehensive or fearful
• Feeling worried
• Feeling that things are "out of control" or endless
• Feeling irritable, restless or edgy
• Feeling stressed or tense, sometimes physically in the muscles with neck or backache
• Having fast or irregular heartbeats
• Sweating
• Having an unsettled stomach, possibly with diarrhea or nausea
• Shaking or trembling
• Having nightmares or vivid images during waking hours of a particularly traumatic part of your cancer treatment

Depression

Depression is also treatable. It affects 15 percent to 25 percent of cancer patients and about 25 percent of cancer survivors. Depression is more than just crying and feeling sad; it can affect your quality of life, including your sexuality. In fact, loss of desire is a classic symptom of depression. Other emotional and physical symptoms include:

• Feeling sad, drained, restless, irritable, or anxious
• Losing interest in activities that you used to enjoy
• Feeling hopeless, helpless, guilty, or worthless
• Losing emotional expression--as if your emotional reactions are inappropriate or nonexistent
• Withdrawing socially from family, friends, pets, and other loved ones
• Experiencing problems with thinking clearly, such as having trouble concentrating, remembering, or making decisions
• Losing your appetite with weight loss, or overeating and gaining weight
• Having disrupted sleep, such as insomnia (sleeplessness), oversleeping, or waking up early
• Abusing drugs or alcohol
• Having thoughts of death or suicide